The importance of HPV types and endocervical curettage in colposcopic examination for the diagnosis of cervical lesions

INTRODUCTION: Cervical cancer is the third most common gynecologic cancer diagnosis. It is a type of cancer that can be predicted with effective screening because there is a factor such as human papillomavirus (HPV), which can be considered etiologically responsible. The main objectives of our study are to investigate whether high-risk HPV (hrHPV) 16, 18 and other hrHPV genotypes revealed by HPV genotyping require a different approach and to evaluate whether simultaneous endocervical curettage (ECC) is required during colposcopy.
METHODS: HPV genotypes, colposcopic biopsy, and ECC results of HPV DNA-positive patients between the ages of 25–65 years. HPV types other than HPV 16 and 18 were grouped as hrHPV types. Smear results, biopsy results, and ECC results were compared. The correlation between colposcopic biopsy and ECC results was evaluated.
RESULTS: The mean age of the 111 patients included in the study was 44.48±8.34 years. There was a statistically insignificant relationship between HPV 16 and/or 18 and other genotypes (p=0.067). A similar trend was present in terms of ECC (p=0.072). In the comparative evaluation of the patients who underwent ECC with colposcopic biopsy, it was found that colposcopic biopsy was significantly more effective in diagnostic terms (p<0.001). However, cervical intraepithelial neoplasia (CIN) was detected in ECC in 6.8% of the patients whose colposcopic biopsy did not reveal CIN.
DISCUSSION AND CONCLUSION: Even if the lesion margins are clear during the biopsy of the lesion in colposcopy examination, ECC may increase diagnostic accuracy.